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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away

InkaUtexas

By InkaUtexas
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Uncle Boobs
Uncle Boobs

Against my better judgment and several beers deep, I have taken you up on this, potentially ending my streak of totally worthless posts. I have done 3 and 7 day averages only on the Worldometer data. 

Brisketexan
Brisketexan

Daughter’s home. A little PTSD, we’re picking up Whataburger to help.

Coelenterate Fuccboi
Coelenterate Fuccboi

Just try and imagine GreenspointTexas being the person to intubate you as you fight for your life against COVID-19. You’re laying there gasping for air while he chastises you for all the things you li

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Bevo

Bevo 13524

Posted
Posted
On 4/20/2020 at 12:24 PM, Sgt Hulk said:

It's working in LA but thats because no one can afford the fine for being arrested.  I drove from Longbeach to my house on saturday a normally 30-40 min drive was 18 min.  freeways are a ghost town  took me 30 min to get inside a grocery store yesterday due to the line and a few in at a time.  Folks arent congregating in large groups for what i can see.  even in OC and south where the beaches are still open not many surfers in the water on glassy good days

Glassy good days probably mean little surf and little surf means fewer surfers. I know a friend of mine has been going out surfing regularly in Santa Barbara: I know this because he keeps telling me to do shit while he is out surfing and considering that I'm the boss, it is pissing me off.

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B00M

B00M 6280

Posted
Posted
13 minutes ago, Bevo said:

Glassy good days probably mean little surf and little surf means fewer surfers. I know a friend of mine has been going out surfing regularly in Santa Barbara: I know this because he keeps telling me to do shit while he is out surfing and considering that I'm the boss, it is pissing me off.

He sounds like a boss

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BabaYaga

BabaYaga 15208

Posted
Posted
8 hours ago, achooloco said:

They still destroyed their economy. And they instituted short term/part time work visas to help the economy. That are also running out of money.  They might hit herd in their country before us but they’re still Fucked once the rest of Europe decides to visit. 

"Destroyed" is a bit much.  They are heavily dependent upon exports, which is causing issues, and UE is rising, but not like what we are seeing here or in other areas of he EU.  The government has launched relief measures worth about 100bn kronor (£8bn) but still expects GDP to contract by up to 10% this year.

Compare their action to sister Norway, with roughly half the population of Sweden,  it costs them 1.7 billion Norwegian crowns ($160 million) per day just to keep schools shut. Costs include parents missing work to tend to children as well as decreased future productivity based on missed education. 

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Eskimohorn

Eskimohorn 5613

Posted
Posted
"Destroyed" is a bit much.  They are heavily dependent upon exports, which is causing issues, and UE is rising, but not like what we are seeing here or in other areas of he EU.  The government has launched relief measures worth about 100bn kronor (£8bn) but still expects GDP to contract by up to 10% this year.
Compare their action to sister Norway, with roughly half the population of Sweden,  it costs them 1.7 billion Norwegian crowns ($160 million) per day just to keep schools shut. Costs include parents missing work to tend to children as well as decreased future productivity based on missed education. 

Can we end comps to Sweden’s controlled exposure program?

Herd immunity = 70% exposure. That’s a minimum standard. You want 90% to eradicate. Do you disagree?

What would happen to the US if 70% people got exposed? Over a million deaths over normal mortality, conservatively.

Other unknowns...
>CV19 antibodies test efficacy
>Immunity efficacy
>Mortality rates, which when looking at overall mortality rates in 7 sample states are clearly being underreported.
>Our testing and tracing capacity

Similarities between Swedish culture, demographics, and government:
>We like ABBA
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Anastasis

Anastasis 23393

Posted
Posted
1 hour ago, bigup2dahorns said:

Gilead news

https://www.businesswire.com/news/home/20200429005424/en/Gilead-Announces-Results-Phase-3-Trial-Investigational

Posted this on the #stonk thread, because I am inclined to short GILD each time they pull one of these bullshit announcements. 

I believe that this is the right study. https://clinicaltrials.gov/ct2/show/NCT04280705  The primary endpoint they are touting is time to recovery.  They are quiet on the secondary mortality endpoints in the releases that I read. I be interested to hear @ChiTownDoc @Newdoc and others chime in, I would be more interested if it actually reduces mortality, time to discharge, hospitalization days, etc. A time to recovery outcome could represent a very modest benefit, similar to antivirals for treatment of flu. They also bloated the release up with some open label results that don't provide any real insight into effectiveness.  

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Iceman

Iceman 2639

Posted
Posted
1 hour ago, Loco said:

Just another day at the bleach

Outcry as Spanish beach sprayed with bleach in an attempt to protect children from coronavirus

https://twitter.com/BBCWorld/status/1255473787946127361

That makes no sense.  They just barely relaxed restrictions this past weekend in Spain, saying kids can go outside and play for an hour at a time and people cannot go more than a kilometer from home.

They fine the fuck out of people in non compliance too.  Son said it was about 300Euros if you got busted being out in town and not being directly on your way to work, the store, or home.

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Incredulity

Incredulity 11559

Posted
Posted
2 hours ago, wild_turkey said:

Can you or someone else explain why a restaurant would find it financially feasible to be open for carryout but not open for 25% dine-in capacity? It seems like overhead and food costs would be very similar. The only obvious difference I see is whether or not to pay waitstaff, which I would think that relatively small expense would be offset by an increase in alcohol sales for people who dine-in.

beyond waitstaff would be the challenges with site cleaning and customer flow/distancing.  I would suspect there will be additional personnel need for those tasks.

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Newdoc

Newdoc 3429

Posted
Posted (edited)
19 minutes ago, Anastasis said:

I would be more interested if it actually reduces mortality, time to discharge, hospitalization days, etc.

I don’t like this release bc it’s the same old pharma BS in comparing the drug against itself. I want to see placebo controls but don’t know if that is ethical in compassionate use situations.

Also, the protocols are all borked from a surface glance. The drug is given to various people at various stages in their illness. End points appear to discharge or death. You’re going to need a LARGE sample size to get good data out of that.


In defense of the company, the drug may fare better if given to a larger, low acuity population earlier in their illness. The way most antivirals work is to cease replication of the virus. Giving the medicine to someone with a high viral load is trying to plug a damn after it breaches.

Edited by Newdoc
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Anastasis

Anastasis 23393

Posted
Posted
1 minute ago, Newdoc said:

I don’t like this release bc it’s the same old pharma BS in comparing the drug against itself.

There are two studies mentioned in the release I saw. The NIAID study is placebo controlled. GILD bloated their release by mixing in open label data from a separate study, which is deliberately misleading imo.

2 minutes ago, Newdoc said:

You’re going to need a LARGE sample size to get good data out of that.

I got a few ideas where they could go to recruit. :)

2 minutes ago, Newdoc said:

In defense of the company, the drug may fare better if given to a larger, low acuity population earlier in their illness. The way most antivirals work is to cease replication of the virus. Giving the medicine to someone with a high viral load is trying to plug a damn after it breaches.

Here are the inclusion criteria from the NIAID study. 

  1. Has laboratory-confirmed SARS-CoV-2 infection as determined by polymerase chain reaction (PCR) or other commercial or public health assay in any specimen, as documented by either or the following:

    • PCR positive in sample collected < 72 hours prior to randomization; OR
    • PCR positive in sample collected >/= 72 hours prior to randomization, documented inability to obtain a repeat sample (e.g. due to lack of testing supplies, limited testing capacity, results taking >24 hours, etc.) AND progressive disease suggestive of ongoing SARS-CoV-2 infection.

  2. Illness of any duration, and at least one of the following:

    • Radiographic infiltrates by imaging (chest x-ray, CT scan, etc.), OR
    • SpO2 < / = 94% on room air, OR
    • Requiring supplemental oxygen, OR
    • Requiring mechanical ventilation.

 

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BabaYaga

BabaYaga 15208

Posted
Posted
7 minutes ago, Eskimohorn said:


Can we end comps to Sweden’s controlled exposure program?

Herd immunity = 70% exposure. That’s a minimum standard. You want 90% to eradicate. Do you disagree?

What would happen to the US if 70% people got exposed? Over a million deaths over normal mortality, conservatively.

Other unknowns...
>CV19 antibodies test efficacy
>Immunity efficacy
>Mortality rates, which when looking at overall mortality rates in 7 sample states are clearly being underreported.
>Our testing and tracing capacity

Similarities between Swedish culture, demographics, and government:
>We like ABBA

So we lock down the world for a year?  Twp years?  Three years?  How long?  How many trillions lost?  Business destroyed?  What is the end game?  Today, right now - there are no known vaccines for ANY corona virus.  A decade ago SARS rolled through. Still not vaccine.  The initial SIP was espoused as a flattening of the curve.  It's so flat now it's just a line.  Then it morphed into transmission, then vaccines, and it keeps dancing along.

Funny how when comparing demographics from either the right or the left with Sweden it suits their argument.  For those in favor of a greatly expanded welfare state, demographics are not mentioned, but when discussing COVID, it's a part of the discussion.  

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Brisketexan

Brisketexan 104557

Posted
Posted
1 minute ago, Newdoc said:

I don’t like this release bc it’s the same old pharma BS in comparing the drug against itself. I want to see placebo controls but don’t know if that is ethical in compassionate use situations.

Also, the protocols are all borked from a surface glance. The drug is given to various people at various stages in their illness. End points appear to discharge or death. You’re going to need a LARGE sample size to get good data out of that.


In defense of the company, the drug may fare better if given to a larger, low acuity population earlier in their illness. The way most antivirals work is to cease replication of the virus. Giving the medicine to someone with a high viral load is trying to plug a damn after it breaches.

Appreciate the post.  So, as far as therapies, let's say there's hope with 1) Remdesivir as an anti-viral therapy, and there's hope with 2) anti-cytokine storm drugs, like Colchicine.  I mean, we still need to find out for sure, but it SEEMS like there's some promise there.

BUT....for both...it appears that early intervention is key -- treat the patient before the virus is running wild in them, and before the cytokines have gone nuts in them.  SO, in developing a plan for treatment, we need to:

1) figure out one or more therapies that can help with early intervention,

2) find a way to diagnose people BEFORE their case gets severe, so that the therapies can be provided early in the case.

Am I on track here?

 

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SizzleChest

SizzleChest 8275

Posted
Posted
5 minutes ago, Newdoc said:

Giving the medicine to someone with a high viral load is trying to plug a damn after it breaches.

Yup.  This is about finding treatments that work depending on stage and comorbidities.  Treating a patient with remdesivir when the cytokine storm has kicked off is not going to work in most cases.  If Regeneron's drug is successful in clinical trials, that would be the one to use at that stage.

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Anastasis

Anastasis 23393

Posted
Posted
7 minutes ago, SizzleChest said:

Yup.  This is about finding treatments that work depending on stage and comorbidities.  Treating a patient with remdesivir when the cytokine storm has kicked off is not going to work in most cases.  If Regeneron's drug is successful in clinical trials, that would be the one to use at that stage.

 Or genentech's?

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Enchubben

Enchubben 5509

Posted
Posted
15 minutes ago, Newdoc said:

I don’t like this release bc it’s the same old pharma BS in comparing the drug against itself. I want to see placebo controls but don’t know if that is ethical in compassionate use situations.

Also, the protocols are all borked from a surface glance. The drug is given to various people at various stages in their illness. End points appear to discharge or death. You’re going to need a LARGE sample size to get good data out of that.


In defense of the company, the drug may fare better if given to a larger, low acuity population earlier in their illness. The way most antivirals work is to cease replication of the virus. Giving the medicine to someone with a high viral load is trying to plug a damn after it breaches.

You seem smart. And reasonable. What the fuck are you doing on surly?

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dcar00

dcar00 14030

Posted
Posted
38 minutes ago, Eskimohorn said:


Can we end comps to Sweden’s controlled exposure program?

Herd immunity = 70% exposure. That’s a minimum standard. You want 90% to eradicate. Do you disagree?

What would happen to the US if 70% people got exposed? Over a million deaths over normal mortality, conservatively.

Other unknowns...
>CV19 antibodies test efficacy
>Immunity efficacy
>Mortality rates, which when looking at overall mortality rates in 7 sample states are clearly being underreported.
>Our testing and tracing capacity

Similarities between Swedish culture, demographics, and government:
>We like ABBA

Yes we should end comps to Sweden for you because they didn't BALLGAME, like so many predicted.

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Bozo_Casanova

Bozo_Casanova 26277

Posted
Posted
18 minutes ago, BabaYaga said:

Funny how when comparing demographics from either the right or the left with Sweden it suits their argument.  For those in favor of a greatly expanded welfare state, demographics are not mentioned, but when discussing COVID, it's a part of the discussion.  

image.png?w=680

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Hate

Hate 20103

Posted
Posted
So says the guy whose avatar doesn’t ever complete the titty flop.
Boooooooooo!

Oh she does complete it and they are spectacular. Amongst the most spectacular I have ever seen. Alexandra Daddario is her name if you want to search for the clip. It will be very much worth your time.
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Brisketexan

Brisketexan 104557

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Posted

Just sharing an amusing comment from a Swedish acquaintance, calling out their viking tendencies:

Quote

well that is how the world look upon us now, because we dare to challenge death, it's in our genes to sail into darkness with no idea if we will survive.

At least made me chuckle.

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Newdoc

Newdoc 3429

Posted
Posted

“It's a strange reality that in the midst of a pandemic, we have a healthcare-led recession.”

The pandemic has shone a very bright light into the utter cluster that is the economics of US healthcare. Even well meaning non profits know their bread and butter is doing stuff to patients, not actually keeping them healthy. Whole health systems are predicated on making the economic engine of elective procedures king of the hill.
 

It’s why primary docs make 1/2 of the median income of specialists and why crazy smart endocrinologists that actually keep people alive make 1/4 of orthopedic surgeons.

This is a rabbit trail for the Covid discussion but we are staring at the insolvency of many private or small group practices across the country. That will affect healthcare for a long time.

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Cheeseweasel

Cheeseweasel 26437

Posted
Posted
4 minutes ago, Newdoc said:

“It's a strange reality that in the midst of a pandemic, we have a healthcare-led recession.”

The pandemic has shone a very bright light into the utter cluster that is the economics of US healthcare. Even well meaning non profits know their bread and butter is doing stuff to patients, not actually keeping them healthy. Whole health systems are predicated on making the economic engine of elective procedures king of the hill.
 

It’s why primary docs make 1/2 of the median income of specialists and why crazy smart endocrinologists that actually keep people alive make 1/4 of orthopedic surgeons.

This is a rabbit trail for the Covid discussion but we are staring at the insolvency of many private or small group practices across the country. That will affect healthcare for a long time.

I'd love for you to unpack this. Are you saying that much of what passes as "medicine" these days is unnecessary? 

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bigup2dahorns

bigup2dahorns 3343

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Posted

Anyone who shops at Costco will be required to wear a mask beginning on Monday, the warehouse retailer said on its website Wednesday.

"All Costco members and guests must wear a mask or face covering that covers the mouth and nose at all times while at Costco," the retailer said.

Exceptions to this rule are children under the age of 2 and those who are unable to wear a mask because of a medical condition.

"The use of a mask or face covering should not be seen as a substitute for social distancing," according to Costco. "Please continue to observe rules regarding appropriate distancing while on Costco premises. Thank you for your understanding and cooperation."

Several states already require residents to wear masks when they are in public.

The new mask requirement at Costco stores comes in addition to many other changes that have been made at stores in the last several weeks.

"The changes we’ve made to our business are too numerous to list," Costco President and CEO Craig Jelinek said in an open letter to customers, "But some examples include: limits in our locations on the number of members; social distancing in lines; enhanced sanitation; limited services in certain businesses; modified weekday hours; plexiglass shields at checkstands; and special hours for seniors and high-risk groups.

"A few examples of how we are taking care of our employees include: premium pay; paid time off for higher-risk employees; protective masks and symptom screenings; and remote work for our office employees," he added.

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Newdoc

Newdoc 3429

Posted
Posted
1 minute ago, Cheeseweasel said:

I'd love for you to unpack this. Are you saying that much of what passes as "medicine" these days is unnecessary? 

It would take pages to unpack. In a macro sense, yes, a large percentage of care is unnecessary. But even if it wasn’t, our payment incentives are perverse.

Even if hospitals were full of all insures Covid patients they would go into the red without the profitable reimbursement from higher profit items like advanced and interventional radiology, cardiac and ortho procedures, etc.

A hospital is considered doing well if there is more than 3% profit annually. No wiggle room there. Most hospital systems that own primary care lose money on all the outpatient clinics. The clinics feed the hospital however. Now you start to see why I use the word “perverse”.

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UT_OB1

UT_OB1 2200

Posted
Posted
8 hours ago, justhookit said:

As long as they aren’t pouring in from NY I don’t see the problem.

But seriously we have the same issue here in Texas. Our ex-mayor of Port Aransas was on the news today begging people to come down “you don’t have to fly!” ‘Our hotels and rentals open Friday”. I keep asking where all 30,000 people that come down this weekend are going to eat since almost nothing is open or planning to open.  Nobody seems to want to answer that. Can’t wait until the 1 grocery store in town runs out of food. Next  2 months are going to be really interesting. Hopefully the low numbers we’ve seen here 7/3500 have something to do with the weather (and all 7 either got it after traveling or got it directly from someone who did travel).

I can’t speak for Port A, but I do have 2 Airbnbs in Galveston, and while things are picking up, we still aren’t close to “normal” levels of searches and bookings in the area. I’d say the overwhelming majority are still too nervous to book, and not just for fear of getting the virus, but also the uncertainty around what is open now (how many restaraunts for example) and what may or may not be open by the time they come stay.  

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BabaYaga

BabaYaga 15208

Posted
Posted
49 minutes ago, Don Johnson said:

 

 

 

The after-action on this is going to be horrendous.  How many missed diagnosis' were attributed to this?  Missed mammograms?  Cancer screenings of other types?  Blood tests?  Echo/cardio tests?  Acute issues, such as what we see at the VA?  Long-term implications of missed PT/rehab?  Or the less life-threatening issues managed by endocrinologists, etc?  Auto-immune disorders impact so many people that require regular screenings and blood tests.  

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dcar00

dcar00 14030

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Posted
22 minutes ago, bigup2dahorns said:

Anyone who shops at Costco will be required to wear a mask beginning on Monday, the warehouse retailer said on its website Wednesday.

"All Costco members and guests must wear a mask or face covering that covers the mouth and nose at all times while at Costco," the retailer said.

Exceptions to this rule are children under the age of 2 and those who are unable to wear a mask because of a medical condition.

"The use of a mask or face covering should not be seen as a substitute for social distancing," according to Costco. "Please continue to observe rules regarding appropriate distancing while on Costco premises. Thank you for your understanding and cooperation."

Several states already require residents to wear masks when they are in public.

The new mask requirement at Costco stores comes in addition to many other changes that have been made at stores in the last several weeks.

"The changes we’ve made to our business are too numerous to list," Costco President and CEO Craig Jelinek said in an open letter to customers, "But some examples include: limits in our locations on the number of members; social distancing in lines; enhanced sanitation; limited services in certain businesses; modified weekday hours; plexiglass shields at checkstands; and special hours for seniors and high-risk groups.

"A few examples of how we are taking care of our employees include: premium pay; paid time off for higher-risk employees; protective masks and symptom screenings; and remote work for our office employees," he added.

weird.  the costco by me has been requiring them for shoppers for at least 2 weeks.

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Cheeseweasel

Cheeseweasel 26437

Posted
Posted
Just now, BabaYaga said:

The after-action on this is going to be horrendous.  How many missed diagnosis' were attributed to this?  Missed mammograms?  Cancer screenings of other types?  Blood tests?  Echo/cardio tests?  Acute issues, such as what we see at the VA?  Long-term implications of missed PT/rehab?  Or the less life-threatening issues managed by endocrinologists, etc?  Auto-immune disorders impact so many people that require regular screenings and blood tests.  

Yeah, I feel like the impact in all areas is going to be hard.

I also feel like we've gone from the "we need to flatten the curve" phase to the "we need to prevent everyone from getting sick" phase. This is where the real debate will begin. 

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Sgt Hulk

Sgt Hulk 13644

Posted
Posted
5 minutes ago, BabaYaga said:

The after-action on this is going to be horrendous.  How many missed diagnosis' were attributed to this?  Missed mammograms?  Cancer screenings of other types?  Blood tests?  Echo/cardio tests?  Acute issues, such as what we see at the VA?  Long-term implications of missed PT/rehab?  Or the less life-threatening issues managed by endocrinologists, etc?  Auto-immune disorders impact so many people that require regular screenings and blood tests.  

I've been trying to schedule an appt with my cardiologist for over a month now.   i guess if something happens they can label it corona related 

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